The two main aims of the drugs that are available for people with MS are to either ease specific symptoms (symptomatic therapies), or reduce the risk of relapses and disease progression (these are known as ‘disease modifying therapies.’) Acute relapses are also sometimes treated using steroids to help shorten the attack and reduce its severity. The types of drugs used in treatment depend on a number of factors, including the person's type of MS.
Some of the drug treatments available include:
- Disease modifying therapies, also called immunotherapies, work by modifying the activity of the immune system to slow the frequency and severity of attacks to the central nervous system. This means the myelin sheaths are subjected to less damage. These medications are most often prescribed for people with relapsing-remitting MS.
- Steroid medication (such as methylprednisolone) is often used to control the severity of an MS attack, by easing inflammation at the affected site
- Immune suppressants such as methotrexate or mitoxantrone, are sometimes used, especially for people with progressive MS
Generic medications for MS
The MS therapy landscape is continuously evolving and from 2019 it is likely that generic disease-modifying therapies will become available to treat MS in Australia.
You can read our factsheet here on 'Generic medications for MS' here.
Get advice about medications
MS Australia does not recommend a particular therapy as this is a clinical decision which you need to make with your neurologist.
MS staff can provide detailed information about medications and discuss what's important in your personal decision making process: contact your state MS society.
Summary of MS Treatments
MS is a very variable disease. In addition, everyone responds differently to different medications and may experience different side-effects.
It is difficult to directly compare the effectiveness of different MS medications as in most cases they have not been directly tested against each other in what is known as ‘head-to-head’ clinical trials.
Life circumstances may also affect treatment choices for each individual – e.g. other medical conditions, family planning, employment, travel, etc.
It is therefore important to discuss the pros and cons of any medication that is recommended for you by your neurologist in relation to all of these factors.
More detail on each of these medications can be found in our medications factsheets (set out below) that summarise the key information, including potential side effects, to provide you with background information that you can then discuss with your healthcare providers.
A summary of the information in these fact sheets is available here.
Medications Fact Sheets
Disease Modifying Therapies:
Aubagio® (teriflunomide)
Oral, one 14 mg tablet per day
Aubagio® (for RRMS) has been shown to reduce the frequency of relapses and delay progression of physical disability by stopping certain immune cells involved in the damage associated with MS from multiplying.
Aubagio (teriflunomide) PDF fact sheet
(See also 'Generic medications for MS' above)
Avonex (interferon beta-1a)
Injection, 30 microgram dose taken weekly
Avonex® (for RRMS) has been shown to slow down activity and disease progression in MS, by reducing both inflammation and the immune response that is attacking the body’s own myelin.
Avonex (interferon beta-1a) PDF fact sheet
Betaferon® (interferon beta-1b)
Injection, every second day
Betaferon® (for RRMS) is used to reduce the accumulation of permanent physical disability, exacerbation frequency and disease activity, by reducing inflammation and the immune response that is attacking the body’s own myelin.
Betaferon (interferon beta-1b) PDF fact sheet
Copaxone® (glatiramer acetate)
Injection, either 40mg/mL three times a week, or 20mg/mL once daily
Copaxone® (for RRMS) reduces the accumulation of permanent physical disability, exacerbation frequency and disease activity by acting as a “chemical decoy” which diverts an immune attack away from the myelin.
Copaxone (glatiramer acetate) PDF fact sheet
Gilenya® (fingolimod)
capsule, once a day
Gilenya® (for RRMS) reduces damage to the nerve cells in the brain and spinal cord, by preventing white blood cells (lymphocytes) from crossing from the lymph glands into the central nervous system and causing inflammation and damage.
Gilenya (fingolimod) PDF fact sheet
Lemtrada® (alemtuzumab)
intravenous infusion, see fact sheet for details.
Lemtrada® (for RRMS) may reduce the impact of the disease on the nervous system by binding to and killing immune cells involved when the immune system attacks myelin. It is thought that immune cells which grow back after treatment do not cause damage to nerves.
Lemtrada (alemtuzumab) PDF fact sheet
Ocrevus® (ocrelizumab)
intravenous infusion, see factsheet for details.
Ocrevus® (for RRMS and PPMS) is used to delay the progression of physical disability and to reduce the frequency of relapse by attacking and destroying specific targets in the immune system thought to be involved when the immune system attacks the myelin around nerve cells.
Ocrevus (ocrelizumab) PDF fact sheet
MAVENCLAD® (Cladribine)
tablets, two treatment courses over two years, see factsheet for details.
MAVENCAD® (for RRMS) is used to reduce inflammation in the nervous system caused by MS, resulting in fewer relapses, less disease activity in the brain and less progression of disability by reducing the number of certain types of white blood cells, thought to be involved in the abnormal immune response which attacks the myelin coating of nerve cells.
MAVENCLAD (Cladribine) PDF fact sheet
Mayzent® (siponomod)
tablet, once a day
Mayzent® (for SPMS) is used to reduce immune attack on nerve cells in the brain and spinal cord by causing white blood cells (lymphocytes) to be retained in the lymph glands thus decreasing the number of these cells circulating in the blood and reaching the brain.
Mayzent (siponomod) PDF fact sheet
Plegridy® (peginterferon beta-1a)
Injection, once every two weeks
Plegridy® (for RRMS) has been shown to slow down activity and disease progression in MS by reducing both inflammation and the immune response that is attacking the body’s own myelin.
Plegridy (peginterferon beta-1a) PDF fact sheet
Rebif® (interferon beta-1a)
injection, three times a week.
Rebif® (for RRMS) has been shown to slow down activity and disease progression in MS, by helping regulate the immune system, reducing attacks on myelin, and as a result, significantly decreasing the frequency of MS relapses and slowing down the accrual of disability.
Rebif (interferon beta-1a) PDF fact sheet
Tecfidera® (dimethyl fumarate)
Oral capsule, 120mg twice daily / 240mg twice daily (after first 7 days)
Tecfidera® (for RRMS) can reduce relapse rates and delay the progression of disability by reducing the inflammation caused when the immune system attacks myelin and protecting nerve cells from damage caused during the immune attack.
Tecfidera (dimethyl fumarate) PDF fact sheet
Tysabri® (natalizumab)
infusion, once every 28 days
Tysabri® (for RRMS) is used to reduce the accumulation of permanent physical disability, exacerbation frequency and disease activity by binding to immune cells in the blood stream, preventing them from passing from the blood into the central nervous system where they can damage nerves.
Tysabri (natalizumab) PDF fact sheet
Zeposia® (Ozanimod), an oral treatment for Relapsing Remitting MS (RRMS), was included on the March 2020 Pharmaceutical Benefits Advisory Committee (PBAC) agenda, however the PBAC deferred making a recommendation for this treatment as the outcome of the Therapeutic Goods Administration (TGA) registration process for ozanimod was not yet available.
(A fact sheet for ozanimod will be available following provision of Consumer Medicine Information by the sponsor. For more information about ozanimod, please visit: https://msra.org.au/news/ozanimod-shows-promise-in-rrms-clinical-trials/)
Symptom Management:
There are therapies available for treating specific symptoms of MS that work without altering the course of the disease. This includes treatments for muscle problems such as stiffness and tremors, fatigue, neurological symptoms such as visual disturbances, incontinence and neuropsychological problems such as depression, anxiety or memory difficulties.
Botox® (botulinum toxin type A)
injection directly into the muscle, frequency based upon use.
Botox® can be used for the relief of muscle spasticity that is localised to a particular region of the body such as the hand, arm or leg, and also for the treatment of urinary incontinence.
Botox (botulinum toxin type A) PDF fact sheet
Fampyra® (fampridine)
tablet, one in the morning and one in the evening
Fampyra® is used in adult people with MS to improve walking. This medicine is thought to work by letting signals pass down the nerve more normally, allowing people to walk better.
Fampyra (fampridine) PDF fact sheet
Sativex® (nabiximols)
mouth spray (the number of sprays needed varies between different people)
Sativex® is used to improve symptoms related to muscle stiffness (spasticity) in MS when other medicines have not worked.
Other symptomatic treatments that may sometimes be recommended for people living with MS may include, for example:
Baclofen – for muscle control and to alleviate spasticity
Naltrexone – to address fatigue and depression
Ditropan, Betmiga – for bladder dysfunction
The treatment of symptoms associated with MS often goes beyond medications and may involve forms of therapy, exercise, dietary changes and the use of aids and equipment.
For more information about particular symptoms and ways to address them, please visit our symptoms page.
Clinical Trials
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